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  1. Carneiro, Luciene Moraes MSci, RN
  2. Mousquer, Gina Jonasson MSci, BPharm
  3. Pinheiro, Raquel Silva RN
  4. Motta Castro, Ana Rita Coimbra PhD, MSci, BPharm
  5. Da Silva Franca, Divania Dias MSCN, RN
  6. Caetano, Karlla Antonieta Amorim MSCN, RN
  7. dos Santos Carneiro, Megmar Aparecida PhD, MSci, BPharm
  8. Martins, Regina Maria Bringel PhD, MSci, BPharm
  9. de Matos, Marcos Andre MSCN, RN
  10. Castro, Lisie BPharm
  11. Rezende, Grazielli BPharm
  12. Teles, Sheila Araujo PhD, MSci, RN


Objectives: To evaluate the hepatitis B immunization status of female sex workers (FSWs) in Central-West Brazil and to evaluate their compliance with and immune response to hepatitis B vaccination delivered using outreach strategies.


Methods: A total of 721 FSWs recruited in 2 large cities in Central-West Brazil were interviewed and screened for the presence of hepatitis B virus (HBV) markers. Hepatitis B vaccine was offered to all women susceptible to HBV, using outreach strategies. The immune response of FSWs who received a full course of vaccine was assessed following the final vaccine dose.


Results: We found that 27.6% of FSWs, the majority of whom were aged 18 to 25 years, had serological evidence of previous hepatitis B vaccination. A total of 434 FSWs were eligible for vaccination, 389 (89.6%) of whom accepted the first hepatitis B vaccine dose. Of those, 64% received a second dose and 37.5% received all three doses. Through the outreach strategy, there was a 52.2% increase in the number of women who received the second dose and a 67% increase in the number who received the third dose. Of the 146 women who received a full course of vaccine, 105 accepted testing for quantitative anti-HBs (hepatitis B surface antibody) following the final vaccine dose, and 92.4% of those tested had developed protective levels of anti-HBs. Lower education level, workplace, and length of prostitution were predictors of full-vaccine acceptance.


Conclusions: The present findings illustrate the benefits of using outreach strategies to overcome the difficulties of vaccinating hard-to-reach populations such as FSWs.